Provider Demographics
NPI:1366209900
Name:GUIMARAES, KEILA (LAC, MSOM, DACM)
Entity type:Individual
Prefix:DR
First Name:KEILA
Middle Name:
Last Name:GUIMARAES
Suffix:
Gender:F
Credentials:LAC, MSOM, DACM
Other - Prefix:DR
Other - First Name:KEILA
Other - Middle Name:
Other - Last Name:GUIMARAES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, MSOM, DACM
Mailing Address - Street 1:1924 SHADY ACRE CIR
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3142
Mailing Address - Country:US
Mailing Address - Phone:858-699-8565
Mailing Address - Fax:
Practice Address - Street 1:1991 VILLAGE PARK WAY STE 1002D
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1994
Practice Address - Country:US
Practice Address - Phone:760-487-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18412171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist